Remote Customer Experience Specialist

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Fully Remote Customer Experience Specialist plays a critical role in delivering compassionate, seamless service to our valued members — primarily older adults and individuals with disabilities. This role goes beyond answering questions; it is about building caring connections, owning the member experience, and always resolving issues completely and correctly the first time.

This is a fully remote role that requires compliance to work only within the contiguous US.

Remote Customer Experience Specialists take personal responsibility for each interaction — listening deeply, advocating for the member, navigating complex systems, and following through until resolution is achieved. Every contact is an opportunity to make health care easier, clearer, and more supportive for our members.

Hourly Rate: $20 / $21 (CA & NY)

Job Duties/Responsibilities:

• Build caring connections with every member by always leading with empathy, patience, and respect, ensuring members feel heard, supported, and valued throughout every interaction.

• Own each member interaction end-to-end, taking accountability to resolve inquiries during the initial contact and ensuring clear follow-through when additional steps are required.

• Deliver exceptional service by consistently exceeding member expectations and reinforcing a culture focused on trust, compassion, and first-call resolution.

• Accurately respond to member inquiries regarding benefits, eligibility, services, policies, and procedures in a clear, confident, and member-friendly manner.

• Assist members with provider network and claim/reimbursement inquiries, benefit questions related to transportation, food, dental and other support services and needs, proactively identifying solutions and next steps.

• Answer incoming contacts within established service levels while always managing complex and sensitive situations with professionalism and care.

• Thoroughly document all member interactions, actions taken, and outcomes in real time to ensure accuracy, continuity of care and effective resolution.

• Proactively address member complaints, grievances, and disenrollment concerns with goal to resolve by listening for root causes, offering solutions, and escalating appropriately when needed.

• Support outbound outreach initiatives and service programs designed to improve engagement, education, and overall member experience.

• Represent Alignment Healthcare with integrity and positivity, modeling a serving-heart mindset and commitment to excellence in every interaction.

• Participate actively in ongoing coaching, feedback, and learning to continuously strengthen service skills and member advocacy.

Job Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Experience:

• 2+ years of customer service, contact center, or member support experience, preferably in healthcare and/or Medicare Advantage.

Education:

• High school diploma or GED required.

• College degree, Associate’s or Bachelor’s preferred or any equivalent combination of education and work experience

Training:

• Required: Demonstrated ability to use technology and follow detailed workflow instructions.

Required Specialized Skills:

• Minimum typing speed of 40 WPM.

• Proficient in navigating multiple systems simultaneously, including Microsoft Outlook, Word, Excel, CRM and Contact Center solutions.

• On camera presence for 100% Remote training, one on one, team and group meetings.

• Workspace must be free of distractions with the ability to maintain strict confidentiality and compliance with HIPAA regulations.

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